| 陈强,顾锐,邱利华,邱东,王健行,许海军.PRF联合自体骨植入对移植下颌第三磨牙替代下颌第二磨牙的效果初探[J].口腔材料器械杂志,2025,34(1):11-16,37. |
| PRF联合自体骨植入对移植下颌第三磨牙替代下颌第二磨牙的效果初探 |
| Preliminary study on the efficacy of mandibular third molar transplantation combined with PRF and autogenous bone in replacing the mandibular second molar |
| 投稿时间：2024-04-18 修订日期：2024-12-02 |
| DOI：10.11752/j.kqcl.2025.01.02 |
| 中文关键词: 下颌第三磨牙拔除 富血小板纤维蛋白 自体骨 牙周组织 |
| 英文关键词:Mandibular third molar extraction Platelet rich fibrin Autogenous bone Periodontal tissue |
| 基金项目:2023年度江苏省老年健康科研项目（编号：LKM2023047） |
| 作者 | 单位 | E-mail | | 陈强 | 盐城市口腔医院口腔颌面外科, 牙体牙髓科, 盐城 224001
盐城市口腔医院口腔颌面外科, 牙周黏膜科, 盐城 224001 | 66285780@qq.com | | 顾锐 | 盐城市口腔医院口腔颌面外科, 牙体牙髓科, 盐城 224001 | | | 邱利华 | 盐城市口腔医院口腔颌面外科, 牙周黏膜科, 盐城 224001 | | | 邱东 | 盐城市口腔医院口腔颌面外科, 牙体牙髓科, 盐城 224001
盐城市口腔医院口腔颌面外科, 牙周黏膜科, 盐城 224001 | | | 王健行 | 盐城市口腔医院口腔颌面外科, 牙体牙髓科, 盐城 224001
盐城市口腔医院口腔颌面外科, 牙周黏膜科, 盐城 224001 | | | 许海军 | 盐城市口腔医院口腔颌面外科, 牙体牙髓科, 盐城 224001 | |
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| 中文摘要: |
| 目的 探讨PRF 联合自体骨植入对移植下颌第三磨牙替代下颌第二磨牙的疗效。方法 选取2021年1月至2023年12月就诊于本院的122例自体牙移植患者作为研究对象，其中符合条件的共100例，随机分为对照组（n=50）和试验组（n=50）。对照组单纯填充自体骨；试验组采用富血小板纤维蛋白（PRF）联合自体骨，比较两组不同时间移植牙的松动度、ISQ、牙周袋深度、附着丧失、MGVs以及咀嚼效率，统计术后不良反应发生情况，多因素Logistic分析治疗无效的影响因素。采用广义估计方程（generalized estimating equation，GEE）模型分析不同时点、不同方法对移植牙牙周组织的影响。结果 两组临床资料差异无统计学意义。试验组和对照组的治疗成功率分别为 94.00% 和 84.00%，试验组治疗效果显著优于对照组（P<0.05），两组术后1周时，移植牙松动度、ISQ、牙周袋深度、附着丧失、MGVs和咀嚼效率差异均无统计学意义（P>0.05）。1个月、3个月及6个月时，试验组移植牙松动度、牙周袋深度和附着丧失均低于对照组，MGVs和咀嚼效率均高于对照组，3个月和6个月时试验组患者ISQ显著高于对照组（P<0.05）。两组术后均有不良反应出现，对照组和试验组的不良反应总发生率分别为 20.00%和 10.00%（P>0.05）。多因素分析结果显示：松动度、ISQ、牙周袋深度、附着丧失和MGVs是影响临床疗效的危险因素。GEE 模型分析显示，1个月、3个月及6个月时两组患者移植牙牙周组织各指标差异均具有统计学意义（P<0.05）。结论 与单纯填充自体骨相比，PRF联合自体骨对移植牙牙周组织的改进效果更好。 |
| 英文摘要: |
| Objective To evaluate the clinical efficacy of mandibular third molar transplantation combined with platelet-rich fibrin (PRF) and autogenous bone in replacing the mandibular second molar. Methods A total of 122 patients who underwent autogenous tooth transplantation in the hospital from January 2021 to December 2023 were selected as research subjects. Among them, 100 patients met the inclusion criteria and were randomly divided into a control group (n=50) and an experimental group (n=50). The control group received simple autologous bone grafting, while the experimental group received platelet-rich fibrin (PRF) combined with autologous bone. Clinical data were compared between the two groups, including implant mobility, implant stability quotient (ISQ), periodontal pocket depth, attachment loss, mean gray values (MGVs), and chewing efficiency. The incidence of postoperative adverse reactions was statistically analyzed, and the influencing factors of treatment failure were assessed using multivariate logistic regression. A generalized estimating equation (GEE) model was used to analyze the effects of different time points and treatment methods on periodontal tissue outcomes. Results There was no significant difference in baseline clinical data between the two groups. The treatment success rate was 94.00% in the experimental group and 84.00% in the control group, with the experimental group showing significantly better outcomes (P<0.05). At 1 week postoperatively, no significant differences were observed between the two groups in implant mobility, ISQ, periodontal pocket depth, attachment loss, MGVs, or chewing efficiency (P>0.05). However, at 1 month, 3 months, and 6 months, the experimental group exhibited significantly lower implant mobility, periodontal pocket depth, and attachment loss, while demonstrating higher MGVs and chewing efficiency compared to the control group. Additionally, ISQ values in the experimental group were significantly higher than those in the control group at 3 months and 6 months (P<0.05). Postoperative adverse reactions occurred in both groups, with an overall incidence of 20.00% in the control group and 10.00% in the experimental group; however, the difference was not statistically significant (P>0.05). Multivariate analysis indicated that implant mobility, ISQ, periodontal pocket depth, attachment loss, and MGVs were risk factors influencing clinical efficacy. The GEE model analysis revealed statistically significant differences in periodontal tissue indices between the two groups at 1 month, 3 months, and 6 months (P<0.05). Conclusion PRF combined with autogenous bone grafting is more effective in improving periodontal tissue health compared to autogenous bone grafting alone. |
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